Self Harm – What are the real facts?

In 2014, the World Health Organisation reported that the prevalence of self harm in teenagers had tripled in the previous decade. Estimates suggest that at least 13% of 11-16 year olds self harm, and true figures could be considerably higher. Assumed mainly to affect girls, more and more boys present with self-harm each year. Between 2012 and 2014, the number of A&E admissions of 11-14 year olds for self harm related reasons rose by 70%, and approximately half of those hospital admissions would have visited their GP in the previous month. Despite campaigns such as the Semicolon Project raising awareness of self harm and the issues associated, the topic remains taboo and stigmatised, with hostility to those presenting. Ultimately, this risks fewer young people coming forward for help.

Myth: ‘It’s just a phase – they will get over it’

Fact: Sometimes self harm is used as a coping response to a stressful situation and will stop when the problem is resolved. However, there is evidence that self harm is addictive, and can become habitual. Studies show that in response to self harm, the brain releases dopamine to compensate for the pain, which may result in a feeling of reward. This cycle can become extremely difficult to break without support.

Myth: ‘They are only doing it to gain attention’

Fact: There are many reasons why a person might begin to self harm, and in some cases it may be a cry for help. But self harm is often private, and those who do it commonly go to great lengths to avoid others noticing it. Even if the self harming is open, individuals can be unaware of the impact on people around them.

Reasons for self harm can be varied. Most often self harmers describe it as a way to feel in control of stressful circumstances, when other strategies seemed to have failed. In other cases it may be a ‘cry for help’ – a way of asking others to recognise emotional distress. In some cases, individuals who self harm feel a need to punish themselves. The latter cases are arguably the most dangerous. In all of these cases careful (non-judgemental) assessment of risk is required.

“Over half of people who commit suicide have a history of self harm.” – NHS Choices

Treatment recommendations are clear. NICE advises that drug treatment is not appropriate for the treatment of self harm. Slee et al (2008) have demonstrated that a time-limited programme of Cognitive-Behavioural Therapy reduces self harming behaviours and suicidal thoughts, as well as reducing comorbid anxiety and depression. In CBT, individuals work on effective problem solving, and management of triggers, while improving self-esteem – techniques which, once developed, reduce the likelihood of recurrence.

For more information, see: Transition: Getting It Right for Young People (UK Government Archives)